Oncology Medical News about pediatric low-grade glioma;conformal radiation

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Phase II trial of conformal radiation therapy for pediatric low-grade glioma
Journal of Clinical Oncology, 07/08/09

Merchant TE et al. - In a study to assess the use of conformal radiation therapy (CRT) to estimate disease control by using a 10-mm clinical target volume (CTV) margin, it was shown that CRT with a 10-mm CTV does not compromise disease control. Results suggest that CRT should be delayed in young pts to reduce risk of vasculopathy.

Methods

78 pediatric pts with LGG and a median age of 8.9 yrs received 54 Gy CRT by using a 10-mm CTV and by targeting with systematic magnetic resonance imaging (MRI) registration.
Tumor locations were diencephalon (n=58), cerebral hemisphere (n=3), and cerebellum (n=17).
67 pts had documented or presumed WHO grade 1 tumors, 25 pts had prior chemotherapy, and 13 pts had neurofibromatosis type 1.

Results

During a median follow-up of 89 mos, 13 pts experienced disease progression.
1 pt experienced marginal treatment failure, 8 experienced local failures, and 4 experienced metastatic failure.
Mean and standard error 5- and 10-yr event-free (87.4% ± 4.4% and 74.3% ± 15.4%, respectively) and overall (98.5% ± 1.6% and 95.9% ± 5.8%, respectively) survival rates were determined.
Mean and standard error cumulative incidences of local failure at 5 and 10 yrs were 8.7% ± 3.5% and 16.4% ± 5.4%, respectively.
Mean and standard error cumulative incidence of vasculopathy was 4.79% ± 2.73% at 6 yrs, and it was higher for those younger than 5 yrs of age at the time of CRT.

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